The Mayo Clinic, Faith, Hope and Science (2018) - full transcript

[Wind howling]

[People speaking indistinctly]

Man: "The sum total of medical
knowledge is now

"so great and wide-spreading
that it would be futile

"for any one man to assume
that he has even a good

"working knowledge of any
large part of the whole.

"The very necessities of the
case are driving practitioners

"into cooperation.

"The best interest of the
patient is the only interest

"to be considered, and in order
that the sick may have

"the benefit of advancing
knowledge, union of forces



is necessary."

Will Mayo.

[Loud thunder]

Narrator: On the early evening
of August 21, 1883,

Will and Charlie Mayo,
the young sons of a local doctor

in Rochester, Minnesota,
were practicing eye surgery

on a sheep's head
at a slaughterhouse

when the butchers urged them
to go home immediately.

A powerful storm was coming.

[Loud thunder]

[Glass breaking]

[Bell tolling]

One of the worst tornadoes in
Minnesota history tore through

the northern end of Rochester.



[Buildings collapsing]

[People crying]

Dr. William Worrall Mayo and
his two sons treated scores

of the wounded in homes,
offices, hotels,

even a dance hall.

Amidst the chaos, the elder
Dr. Mayo asked to see

Mother Alfred of the nearby
Sisters of St. Francis.

It was summer, vacation
time at the convent school

she oversaw.

The students' rooms
were empty, he said;

could they use the beds
for the injured.

She agreed.

Afterwards, Mother Alfred told
Dr. Mayo that she had received

a vision from God instructing
her to build a hospital

in Rochester with Dr. Mayo
as its director.

It would become, she believed,
"world-renowned for its

medical arts."

Within a few years, Mother
Alfred's vision--what people

would call "the miracle in
the cornfield"--came true.

In one of the most unlikely
of partnerships, and in one

of the most unlikely
of places, the Mayos

and the Sisters
of St. Francis

would end up creating
what many believe is

the greatest medical
center in the world.

Woman: I think that there is
a reason so many people come

to Mayo Clinic and have been
for so many years.

It has such a long history
and such a good reputation.

Mayo was the right place
to go and my parents

could see that, too.

When I first came, the
history was powerful to me.

We read the description of
how it was built after

the tornado.

There was a sense of support
in the history and in

the beliefs that those nuns
had had that carries on today,

not even in a religious sense,
but just you feel supported by

that faith and hope.

Yeah.

Let me have
that valve.

Man: I was a child growing up
in the Midwest,

and the Mayo Clinic
was a secular temple.

It was something that we could
all be proud of even if we had

no association with it.

And it was there in Rochester,
Minnesota, like it had

risen up out of the
earth in some way.

Narrator: When William
Worrall Mayo and his sons began

practicing medicine together in
Rochester, Minnesota, a small

town 90 miles southeast of
Minneapolis, there were only

a handful of doctors
in the whole county.

[Siren]

That 3-person practice
has grown into an organization

employing more than 64,000
people, with campuses

in Florida and Arizona and
affiliates all over the world.

For 150 years, the Mayo Clinic
has been confronting age-old

questions about our commitment
to taking care of each other,

about the role of money
and profit in medicine,

and about the very nature
of healing itself.

Man: Imagine for a minute
that you've been told that

the doctors don't know
what's wrong with you

or can't help you.

And then imagine if you will
that you contact Mayo Clinic

and Mayo Clinic says
"We can help you."

Imagine what that does for
that patient in terms of hope

and inspiration and
opportunity going forward

for healing.

That's what this
place is about.

[Second man speaking]

Narrator: Each year, more than
a million patients arrive

at the Mayo Clinic from all
50 states and 150 countries.

During any given 24-hour
period, there will be as

many as 14,000 patients,

9,000 examinations
and 300 surgeries,

5,000 lab specimens
will be evaluated,

4,600 diagnostic procedures
will be conducted,

with 230 radiologists
able to read

the results and report
back within 90 minutes.

In an age when most doctors
operate independently and are

financially rewarded for
ordering a battery of tests

and procedures, every physician
at the Mayo Clinic

is on salary, creating
a culture that thrives

on collaboration.

Dr. Mayo had a simple
philosophy he tried to impart

to his sons: "The needs of
the patient come first."

They wouldn't treat diseases.

They would treat people,

and they would do it with
the Sisters of St. Francis.

Man: Medicine is a science,

but how we interact is layered
with all kinds of other issues--

all of which have
to do with health.

And so if they don't have
faith in the caregivers,

if that patient doesn't have
hope, we're gonna have a lot

of trouble, you know, even
attempting to make them better.

Faith, hope, and science--
those three things are

absolutely critical.

[Sea gulls crying]

Man: "My own religion has been
to do all the good I could

to my fellow man, and as
little harm as possible."

William Worrall Mayo.

Narrator: One day in 1846,
a 27-year-old aspiring doctor

named William Worrall Mayo
went down to the docks

in Liverpool, England and got
on a ship headed to America.

He had been born in 1819
to a middle-class family

near Manchester.

His father was a cabinetmaker
who died when his son was

7 years old, leaving his wife
with 6 children to feed.

At 14, W.W.,
as he would be known,

became a tailor's apprentice,
where he gained experience

with a needle and thread
that would prove invaluable.

He was small, just 5'4", wiry,
and formal, with memorably

piercing blue-gray eyes.

One of his grandsons would
describe him as "snap-tempered,"

"strange, ferocious, striving,
and restless."

He had studied with the
famous chemist John Dalton,

who promoted the theory
that all matter is

composed of atoms.

Dalton was also a Quaker,
and he instilled in W.W. Mayo

a commitment to the scientific
method, to hard work, and to

social justice.

[Bells clanging]

When W.W. arrived in America,
his first job was as a chemist

at Bellevue Hospital in New
York City, where he saw the

full range of human suffering.

Man: Hospitals were places
where the perception was,

that's where you go to die.

There really were almost
no rules or regulations.

They weren't sterile places.

And there really weren't
doctors, as we perceive

of them today.

There were no standards,
in terms of education

for individuals that
claimed they were doctors.

And also, there were a lot of
quacks that toured the country

proclaiming cures for this
disease or that disease.

Narrator: Determined to be
a real doctor, W.W. enrolled

at the Indiana
Medical College.

After graduating in 1850, he
married Louise Abigail Wright,

a 25-year-old strong-willed
woman, who would become

his first assistant.

They moved to Lafayette,
Indiana, where he opened

a practice in a
small drugstore.

When W.W. contracted malaria,
he left the mosquito-infested

marshes of Indiana, telling
Louise he was going to

keep going, "until I
get well or die."

By the time he arrived in St.
Paul, Minnesota, he was well.

But wherever he traveled,
there were either

too many doctors
or not enough patients.

So for the next 10 years,
he worked as a surveyor,

riverboat pilot, newspaper
publisher, and veterinarian.

[Gunfire]

The Civil War brought
Mayo's travels to an end.

At age 43, he was
appointed examining surgeon

for a regional enrollment
board on the edge

of the frontier in
Rochester, Minnesota.

When Louise and their children
caught up with him

in January of 1864,
she told him, "No more.

We're not moving again."

Although two of their children
died in infancy, they would

eventually have two daughters
and two sons, Will and Charlie,

whom they would raise
"in medicine,"

the boys remembered,
"like farm boys on a farm."

[Gunfire]

While W.W. Mayo was
trying to determine

who was fit to fight
for the Union Army,

thousands
of other doctors were

practicing on the battlefield
a medicine that was

almost medieval.

Most of them had never seen
a bullet wound, let alone

performed surgery.

Many sharpened their scalpels
on their boots, carried

surgical tools in their pockets,
and used their own saliva

to wet the silk
used for sutures.

After the war, Mayo began to
build a practice in Rochester,

and his reputation grew.

[Horse neighs]

He usually saw patients
at his downtown office,

but in an emergency, he thought
nothing of taking off

late at night in the middle of
a snowstorm and driving his

horse and buggy at breakneck
speeds to get to a patient's

log or sod home miles away.

He'd quickly determine
the best place to operate,

then proceed to deliver a baby,
set the bone of a farmer,

or amputate a leg
ravaged by gangrene.

If the patient was poor,
W.W. wouldn't charge him.

He also immersed himself in
the latest medical journals,

and began contributing
his own articles as his

expertise increased.

Mayo made several return trips
to Bellevue Hospital, where he

attended lectures, observed
operations and autopsies,

and marveled at
its ambulance corps,

the first in New York City.

But he was most impressed with
an imported German microscope

that cost $600, a fortune.

When he returned to Rochester,
he broached the subject

of mortgaging their house to
pay for the new instrument.

Louise was loath to take on
any more debt, but she thought

about it, and finally said,

"William, if it's of use to
the people, let's do it."

Man: Mayo Clinic has a 100-plus-
year history of investing

in new technology.

"Proton beam" sounds
like this mystical term.

Why can protons revolutionize
radiation therapy?

Because we avoid damaging
normal, healthy tissues.

So who benefits?

Number one, it's patients in
whom we're trying to avoid

critical areas--

for example, young patients
with brain tumors.

[Machine beeping]

Woman: This doctor comes in
and he pulls the chair over to

the bedside, sits down, and he
says, "There's no easy way to

say this, but your daughter
has a mass in her brain."

Get ready.

The neurosurgeons in Salt
Lake City did an amazing job,

but, for me, I always knew
that it wasn't just surgery.

Man: The proton beam, radiation
is what brought us out to

the Mayo Clinic.

I said that I would go to
India if that's the best place

my kid could be.

The Mayo Clinic is my India.

Things happen in life.
People die.

The Mayo Clinic
can't save everybody.

It's not magic.

And blasting my child's head
for 6 weeks while she's

trying to develop, you know,
these cognitive and extremely

important pathways in her
brain--that's just ludicrous.

But when we got to the Mayo
and met with Dr. Keole, he said,

"Hey, you know what,

"I can't promise you anything,
but we're gonna have

"a strategic plan on how to
outmaneuver whatever adversary

you're looking at."

That was different.
That was a big difference.

The Mayo Clinic didn't
happen out of thin air.

And I know the Mayo Clinic
has a reputation, but I didn't

understand what that was.

I'm not gonna know that until
Abigail gets brain cancer.

Man: "When I was 10 years old,

"Father was removing
an ovarian tumor.

"He called me in, and I stood on
a box and gave the chloroform,

"while Will,
who was just 14 years old,

helped with the operation."

Charlie Mayo.

Woman: From the time
they were little boys,

when W.W. went to visit
patients in the country,

Will and Charlie came along
with their father in the buggy.

This buggy became a traveling
schoolroom for the boys.

He encouraged the boys to
observe, and then he would

pose problems.

Narrator: Will and Charlie
began their medical careers

sweeping floors
and washing windows

in their father's office.

Eventually, he would take them
on house calls and let them

help care for patients.

At day's end, they would
always sit together

and discuss what
they had seen.

Louise also helped, assisting
at surgeries, treating injuries,

and counseling patients
who showed up when

her husband was away.

Charlie would later say,
"The biggest thing Will and I

ever did was to pick the
father and mother we had."

Both boys would eventually
go on to medical school--

the older Will at the
University of Michigan

and Charlie at Northwestern.

[Loud thunder]

[Wind whistling]

[Glass breaking,
buildings collapsing]

[Bell tolling]

More than 20 people died
in the tornado that swept

through Rochester that summer
day in 1883 and dozens more

were injured.

The Sisters of St. Francis had
done what they could to help,

but afterwards, Mother Alfred
knew they could have done more.

Then she had her vision of
building a hospital--a place,

she insisted, that would be
open to "all sick persons

"regardless of their color,
sex, financial status,

or professed religion."

Mother Alfred was a 53-year-old
nun who believed that

"the cause of suffering
humanity knows no religion."

Dr. Mayo was a 64-year-old
agnostic who, a newspaperman

remembered, "defended
Darwin by the hour."

Both were stubborn
and impetuous--

driven by a desire to serve.

Mayo was certain Mother Alfred
would be unable to raise

the money.

She could buy the land she
wanted just west of town

for $2,000,

but the building would
cost at least $40,000.

But if she did succeed,
he reluctantly agreed to lead

its medical staff and perform
all his surgeries there while

still running his
practice downtown.

Woman: He thought,
"There's no way they're
gonna raise 40,000."

And she was convinced.

She knew the sisters would

raise that money, and she
would hold him to that.

Narrator: They shook on it.

Woman: Mother Alfred and
William Worrall never drew up

any legal documents.

Their word and that
handshake meant everything.

Narrator: For the next 100
years, every agreement between

the Mayo Clinic and
the Sisters of St. Francis

would be made that way.

Mother Alfred and the
nuns set to work.

They saved every penny
they could from tuitions

at their school.

They gave music lessons as
well, embroidered linens,

chopped their own wood, made
pillow cases out of flour sacks,

and ate the
plainest of meals.

After 5 long years,
in August of 1888,

construction finally began.

Meanwhile, Will and Charlie,
having both graduated from

medical school, were beginning
to play a major role in their

father's practice.

They had become passionate
advocates for a new procedure

developed by a Scottish
surgeon named Joseph Lister,

based on the theory that
germs caused infections.

Most American doctors
were skeptical.

In 1881, President
James A. Garfield had died

not from his
would-be assassin's bullet,

but from his doctors' filthy,
unwashed hands.

But the Mayos were convinced.

They designed and equipped the
operating rooms for the new

hospital specifically to
take advantage of the latest

innovations in sterilization.

There was an air of curiosity,
an imagination, all the way

from the beginning of the--
of the history of the Clinic,

looking for new methods,
new science, new techniques.

They were both forward-looking
and conservative

at the same time.

Narrator:
On September 30, 1889,

the day before the new facility
was to officially open,

the Mayo brothers
performed eye surgery

on a man from Olmsted County.

He was the very first patient
admitted to Rochester's

brand-new hospital.

It was called St. Mary's.

Woman: So, with no more fanfare
than just a blessing,

the hospital was open,

patient was admitted,
had surgery,

and the only thing it says
about him is he got well

and went home.

Narrator: From the
outside, St. Mary's

was an impressive,
modern-looking,

3-story brick building.

But inside, the sisters who
were responsible for taking

care of the patients, couldn't
have asked for a harder test

of their faith.

Woman: They did the nursing.
They did the laundry.

They did the cooking.
They did the cleaning.

They did everything.

Oh, my. They got up at 2:00 and
3:00 and 4:00 in the morning.

They worked
through the day and through

the night until
the next night.

And a lot of times, they gave
up their beds so that there

would be beds for patients.

Narrator: The nuns who lived
and worked at St. Mary's

had trained as teachers,
not nurses.

Edith Graham, a Rochester
native who had completed

nursing school, joined the
Mayos' downtown practice

on 3rd Street,
but she ended up

spending most of her time
a mile away at St. Mary's,

where she took care
of patients and shared her

knowledge with
the sisters.

Of the first 400 surgeries
performed by the Mayos at
St. Mary's Hospital,

only 2 patients died.

I have no idea how the Sisters
took care of patients

with so little,
but they made a way.

And that's one thing about
being a nurse, you make a way

out of no way.

Woman: Two months before I went
to the Mayo Clinic, I started

noticing that I had
double vision,

so I scheduled an appointment
to see the ophthalmologist.

As soon as they said,
uh, something about melanoma,

we just were in shock

'cause all you think
about is the worst.

Will I be able
to stay pregnant?

Man: The same factors that are
letting her baby grow are

allowing the cancer
cells to grow as well.

I've seen these patients that
are pregnant with melanomas.

Their cancer cells
grow exuberantly.

Buck: Dr. Pulido basically
sat down and told me that,

"Your life is at risk.

You really need to think
about terminating."

That was very hard to hear.

What came in my head was,
you know, "Is there another way?

"Can you just take
my eye, please?

Just don't
take my baby."

But he told us that
he is good with the eyes.

He's not good
with the babies.

But he already had the
appointment scheduled

with the OB.

[Speaking indistinctly]

Woman: These are hard
conversations to have.

Whenever you have a mother with
a high-risk medical condition,

you need to have
different providers

with different areas
of expertise.

The impact of pregnancy
on melanomas--I think a lot

of the data
is conflicting.

At that point in time,

the options were still
available for her

in spite of the pregnancy,

but the risk of
metastases is there.

Melanoma's actually one of the
most common cancers that can

spread, even to the fetus.

We reviewed what she wanted
to do, and she was very clear

that she did not want to proceed
with elective termination.

[Machine beeping]

Pulido: For her,
we used a plaque.

It looks like a bottle cap,
and you put radioactive seeds

within it, and then you sew
this on the eye, so the gold

doesn't allow the radiation
to come anywhere else

but into the eye.

Sometimes I deal
with people that die.

[Voice breaking]
I feel that the only way
that I can give them hope...

is if I know in
my heart of hearts

I'm trying to push
the boundaries.

Now it's kind of a wait and
see whether the melanoma cells

are responsive.

How are you?

Buck: We came to find out
about my melanoma

and see if it shrank.

...chest X-ray's
fine as well.

And the tumor is
starting to shrink.

Fantastic!
Ha ha ha!

Buck: My radiation worked.

And so now that the melanoma
is shrinking, it's basically

dead now, which is
very nice. Ha ha!

Pulido: It's pretty
interesting that

the first case done
at St. Mary's

was removal of an eye
for an eye cancer.

[Hoof beats, horse neighs]

Narrator:
Throughout the 1890s,

as Will and
Charlie Mayo took over

their father's practice, the
brothers remained inseparable.

They walked to work together.

They made decisions
together.

They built their first
homes next to each other.

And they shared a bank account,

both signing checks

simply, "Dr. Mayo."

While they both performed
all kinds of surgeries,

Charlie specialized in
delicate operations

on the head and neck.

Will, like his father,
focused on abdominal

and gynecological procedures.

Will was authoritative,
clear-minded, visionary,

a perfectionist.

Charlie was more easy-going,
less intimidating, friendly.

They had their disagreements,
but never in public.

With them, it was never "I."

It was always,
"My brother and I."

Will and Charlie, people in
town said, were "married"

to the practice,

but like their father,
they were also both married to

strong women.

Will's wife Hattie, who had
grown up in Rochester with the

brothers, was shy and formal.

An artist, she mostly stayed
out of medical affairs,

but would end up designing
their houses and serving as

a hostess to doctors and
dignitaries from all over

the world.

Charlie married Edith Graham,
the nurse who was instructing

the sisters at St. Mary's.

She was the opposite of
Hattie--feisty, outgoing,

and an integral part
of the Mayos' practice.

Woman: "The first time Sister
Joseph was asked to assist

"at examining a patient,
she ran into a corner

"of the room and stood
facing the wall, outraged

"and ashamed, because
the man was naked.

"She told Nurse Edith it was
impossible for her to be

"a nurse; she planned
to transfer back to

"teaching immediately.

"But Edith convinced her to
stay, and in less than 3 years,

Sister Joseph
was head of the hospital."

Narrator: Sister Joseph Dempsey
was the second

in a long line of formidable
women who would lead

St. Mary's Hospital, working
closely with the Mayos,

but also maintaining the
Sisters' independence

and their values.

She served as Dr. Will's main
surgical assistant for 25 years

and became so skilled
that she would continue

with an operation when he
turned away to explain

something to visiting
doctors or students.

[Train whistle blows,
engine chugging]

One cold morning, railroad
workers in Waterville, Minnesota

removed a window
from a passenger car

on the Minneapolis-
St. Louis Line

so they could slide a stretcher
in across two seats.

On it was 5-year-old
Lucy Gray.

She was in great pain and
had been feverish for almost

2 weeks.

Her parents were taking her
to Rochester, Minnesota, where

they'd heard about some
country doctors who were

having remarkable success.

A few hours later, she woke up
in a dimly lit room at

St. Mary's Hospital, recovering
from an emergency appendectomy

performed by Dr. Charlie.

Another hour, and it
would have been too late.

But an infection set in.

There was another operation.

And then another.

She was not getting better.

The sisters held late-night
prayers in their chapel.

The youngest nurse played
with her day after day,

making a chain of paper rings,
each ring representing a day

in the hospital, until they
decorated the entire screen

behind her bed.

Lucy Gray lived to age 96.

She always gave the Mayo
brothers and the Sisters' faith

equal credit
for saving her life.

Man: For someone who is,
I would say,

as nonreligious
as Will Mayo was,

to refer to the spiritual
as being so important

for the care of the
patients and the good

of the Clinic to survive,
I think just spoke volumes

about the
Mayos' insights.

If we pay too much attention
to the material nature

of what we do
and ignore the spiritual,

we will amount to
nothing as a clinic.

[Door creaks]

Woman: All of a sudden, your
whole world done change on you.

When I got up,
I couldn't hardly walk.

I was like shuffling my feet,
losing my balance, and I was

like, "Wow, there's something
going on with me, but what?"

I have no idea.

The neurologist doctor,
he said,

"You have myositis,
and there's no cure for it."

And when you have a doctor
that tell you that, it seemed

like all hope is gone.

But I still don't feel like
I have that right answer to

what's going on with me.

Somebody out there may have
a different diagnosis for me.

I know people come from around
the world to get into

the Mayo Clinic
to get a second opinion.

So I called in January, but I
couldn't get an appointment

because they wasn't accepting
new patients at the time,

so the young lady told me,
"Call back in December."

I didn't mention to her,
but when I got off the phone,

I said, "Wow, I hope
I be alive," you know,

'cause we talking about
11 months.

During that time while I was
waiting, I was going downhill,

but I never gave up hope.

Never.

And so when I got accepted in,
that was my world.

It is a second
opinion on my life.

I'm very excited.

I'm looking forward to it.

Man: "The people will demand,

"the medical profession
must supply,

"adequate means for
the proper care of patients,

"which means that
individualism in medicine

can no longer exist."

Will Mayo.

Man: In the late 19th,
early 20th century, medicine

was highly individualistic.

If you were a doctor, you held
your skills close to the vest.

You were afraid of losing money
or prestige or patients.

Trueman: That autonomous doctor
brings to his practice and to

the service of his patients
the knowledge and experience

he has alone.

He misses the opportunity
to enrich that.

And when you're talking about
healthcare and people's lives,

the value of somebody
else's additional
knowledge or experience

could mean the difference
between life and death.

Narrator: By 1892, the elder
Dr. Mayo was 73 years old.

His sons were
confidently in charge.

He decided to step back from
his practice, to indulge

in his other varied interests.

He became a Minnesota State
Senator, loved to travel

and tinker
with machinery.

[Horse neighs]

To handle the ever-increasing
volume of new admissions

at St. Mary's, the Mayo brothers
began to bring other doctors,

including a woman, into
their 3rd Street practice

to examine and diagnose
patients prior to surgery

at the Sisters' hospital.

The arrival of these specialists
signaled something new

and fundamentally
transforming--a collaborative

approach to medicine.

Aksamit: The concept of this
multi-specialty, teamwork-based,

group practice for the
good of a single patient

was maybe the greatest
contribution that

the Mayo brothers brought
to American medicine.

When I'm stuck with a patient,
and I don't have the answer

for a particular patient,

I have no hesitation to share
that patient with another

of my colleagues.

Man: I had a patient with
a very unique condition.

And within 20 minutes, I was
able to speak to the various

sub-specialties that
I needed to contact.

In private practice, it's
really challenging to do that

for a lot of
different reasons.

Man: Many times a patient would
say, "I had to see multiple

"specialists, I couldn't get to
the specialists as fast as I

"needed to, and no one was able
to put it all together to give

me a diagnosis and a
future plan of care."

Behind me and behind every
other physician at Mayo Clinic,

we have 2,400 other physicians
that can help you

take care of a problem
that a patient has.

Brokaw: Several things
stood out for me.

It wasn't just one, um,
kind of A-personality doctor

looking after me.

It was a team, always.

It was always a team,
there at my bedside.

Man: Teamwork is
collective wisdom.

Nobody can know everything,
and I think that's the beauty

of the group practice
that the Mayo brothers

recognized early on.

Narrator:
As the 20th century dawned,

there was as yet no formal
medical center

in Rochester, Minnesota.

There was simply a small
but unique group practice,

now on the second floor
of the Masonic Building,

led by two surgeons and
several associates,

affiliated with a hospital
a mile down the road, run by

a small community of nuns.

Man: "Their hospital in the
little prairie city

"of not more than
5,000 inhabitants has become

"a Mecca for surgeons!

"There is no other
hospital on this side

"of the Atlantic in which
so many important operations

are performed daily."

Narrator: After watching
the Mayos operate,

a well-known Chicago physician
reported to his colleagues

that the brothers were
far more advanced than

most surgeons.

Patients had already
been spreading the word

about the Mayo
brothers for years.

Now more doctors began
to travel to Rochester to

observe, learn, and even
be treated themselves.

Eventually, Charlie had to
design a custom platform

alongside the operating table,
with slanting mirrors above it,

to accommodate the ever-
increasing number of surgeons

who just wanted to
see them work.

Woman: "Both men were entirely
frank about their role,

"constantly telling visitors
where they had picked up
this good thing or that.

"Dr. Will would say, 'I used
to do this differently,

"'but Moynihan showed me
his method when he was here

"and it was better,
so I use it now.'

"And Dr. Charlie--'The first
time I tried this operation,

"'I got stuck at this point,
but Dr. George Monk of Boston

was here, and he
told me what to do.'"

Narrator: On most nights,
visiting doctors

gathered at the "Surgeons'
Club," where they discussed

what they had seen that day.

Increasingly, they began to
refer to the place where they

had witnessed the brothers'
extraordinary work as

"The Mayos' Clinic
at St. Mary's."

Each year, one brother
would take an extended
educational "vacation"

to study different
surgical techniques,

while the other remained
at the practice.

Dr. Charlie and his wife Edith
even attended surgeries

during their honeymoon.

And by the 1920s, Dr. Will
had witnessed procedures

by surgeons in every town
in America and Canada

with a population
of more than 100,000,

and had crossed
the Atlantic 30 times.

Boes: The Mayo brothers really
developed their own continuing

medical education program.

If they heard about a new
procedure, they would go

and see that physician,
watch him do the new surgery,

learn the ins and outs of it,
and then come back

and apply it to Mayo.

They took what others did,
they applied it to a very

large number of patients, and
really kind of perfected it.

And that part still goes on.

Woman: I was diagnosed
with Ebstein's Anomaly
when I was born.

It's a disease of the heart.

In my case, half the blood is
sent in the wrong direction,

and that causes the heart to
not function as efficiently.

I've had the same cardiologist
almost my whole life.

The only reason we decided
not to stay in North Carolina

for this surgery was because
of Dr. Dearani's experience

with Ebstein's Anomaly.

[Door closes]

I'm Dr. Dearani.
Nice to meet you.
Hi.

Jenkins: My surgeon has
only done 15 Ebstein's
Anomaly surgeries...

It probably would be
appropriate for you...

but Dr. Dearani somehow
has managed to do 800.

So the sheer numbers
were just...unbelievable.

Dearani: We are a
destination medical center
treatment, which means

that there are many patients
that will travel for answers.

With Anna, it was a surgeon
who referred her to me--

one of my colleagues,
a very, very good surgeon.

With Anna's case, she's an
elite athlete, and the heart

is getting progressively
enlarged.

Jenkins: The analogy Dr. Dearani
gave me was with a spring.

Everything contracts,
but that area sort of
pooches out...

Jenkins: If you stretch
a spring, which is what
happens with athletics,

it'll bounce back.

But if you stretch a spring
way too far, it gets stuck,

and that's what we
don't want to happen.

I'm a little nervous,

although I don't think I'm
as nervous as my parents are.

It would have been convenient
to stay at home and to not

have flights and to be living
out of a hotel room for a week.

And I know the recovery
will be long,

but knowing that if my heart
enlarges any more, I will not

be able to do any of
the athletics I do,

maybe not even able to
walk up the stairs anymore.

Man: You feel a great
confidence in everyone here,

but you know they've stopped
your daughter's heart, lowered

her body temperature, doing
this intricate procedure.

You feel like you shouldn't be
thinking about things like

how many sugars
are in your coffee.

OK, we're all done...

Jenkins: My nurse just
brought me a rock.

This is the rock she gave me,
and it's shaped like a heart.

She said she brought it
here to bring me peace.

Once my chest plate heals,
6-8 weeks down the road, I hope

to get back into rowing and
join the team and not be

too far behind.

I think my heart
is in a good place.

Narrator: In 1901, the Mayo
brothers hired a young doctor,

Henry Plummer, who had impressed
them with his knowledge

of blood diseases.

They wanted to focus on
surgery, but Plummer helped

convince them that better,
more advanced lab

and diagnostic work would
improve surgical outcomes

or perhaps make those
surgeries unnecessary.

Plummer immediately began
modernizing the Mayos' labs

and exploring ways to make all
the patient information

they were gathering
more accessible.

Man: "The highly scientific
development of this

"mechanistic age had led
perhaps to some loss

"in appreciation of the
individuality of the patient

"and to trusting largely to
the laboratories and outside

"agencies, which tended to
make the patient not the hub

of the wheel, but a spoke."

Man: One of the things
that the Mayos did very

successfully around the early
1900s was that the patient

became the center,
and the doctors orbited

around the patient.

They refocused the--
the circle of care.

Narrator:
William Worrall Mayo

had kept long narratives
about patients

on the back of ledger pages.

Later, his sons and the
doctors who joined

the practice kept
their own, separate

individual case notes.

Ziemer: Each physician
would record the
patient's information,

but then, when the patient came
back, they might not have seen

the same physician, and
so they didn't know what

the other physician
had told the patient.

And so that was very difficult
to know how to treat or move

forward with treatment.

Narrator:
Henry Plummer was determined
to standardize their records.

Mukherjee: The genius of
Plummer's invention was to say,

"The heart does not live in
the cardiologist's office.

"The lung doesn't live in
the pulmonologist's office,

"The spine doesn't live in
the orthopedist's office.

They're part of
the same person."

So, really, to reflect that
wholeness, uh, you needed to

have a medical record that was
attached not to the doctor's

offices, but to the patient
individually and not just

in one single moment of time,
but through all time.

Plummer's invention eventually
spread throughout the whole

nation and eventually
spread through the world.

[Horse neighs]

Narrator:
On July 1, 1907,

a 48-year-old housewife from
British Columbia

arrived in Rochester
with intense nerve pain,

fever, and chills.

The diagnosis was a
gallbladder infection.

After a successful surgery,
she went home.

For Henry Plummer
and his new system,

she was patient number 001.

The Mayo brothers had also
hired a pathologist named

Louis Wilson.

Dr. Will challenged him to
develop a reliable way to tell

if a tissue was cancerous
while the patient was still

on the operating table.

At the time, preparing
tissue samples for analysis

took days.

Wilson developed an ingenious
way to get specimens under

the microscope in less
than 2 minutes.

Dacy: On a bitter day
in January 1905,

Dr. Wilson took
the pathology specimen,

put it on the window sill,
froze it,

and with a little bit
of colored dye, assessed

in one stop whether or not
the patient had cancer.

Man: Literally in a matter of
minutes, he could go back

and tell the operating surgeon,
"It's not a malignant tumor"

or "Yes, the margins of the
edges of the tumor you've

"taken out don't show any
tumor; you don't have to

operate further."

Mukherjee: That was really
pioneered at the Mayo Clinic.

I mean, as an oncologist, as a
cancer doctor, I can tell you

that that is so
crucial to a patient.

Narrator:
Dr. Wilson now insisted that
his lab be situated next to

the operating room, a practice
that continues to this day.

Man: Just a few feet from where
we are right now, there's

a massive pathology lab with
multiple technicians in there

freezing, cutting, staining
slides, two pathologists

reading it--there's nothing
like that anywhere in the world.

Woman: From the
patient's standpoint,

it means that they come in,

they can undergo one operation
to have their tumor removed,

and they can move past
that day, and start moving on

with their lives.

Smoot: The speed with which
we get people answers...

I know by the time
I talk to the family

after the operation what we've
done, if the margins are clear.

It's a great burden lifted
off of them to--to hear

that immediately.

Boughey: Most institutions
don't have the support of their

pathology department.

So a woman goes to the
operating room to remove their

1- or 2-centimeter cancer,
and then that pathology report

may come back a week or two
weeks after surgery.

"Well, the margin is positive,
so we need to consider

a second operation."

Sometimes you have to do
a third operation.

Man: Compared with the rest of
the country, the likelihood

of a repeat operation
is reduced by fourfold.

I don't know why it
hasn't spread more widely.

[Train whistle blows]

[Bell clanging]

Narrator: The Mayos' almost
mythical reputation meant

more patients.

More patients meant
more diagnoses.

More diagnoses
meant more surgeries.

More surgeries meant
more nurses.

And all of it meant
more hospital rooms.

There had already been
3 additions to St. Mary's.

What had begun in 1889 as
a small community hospital,

with only a dozen iron cots
ready for patients, was now

one of the largest and most
advanced surgical centers

in the United States, where
more than 3,000 operations

were being performed
each year.

Fye: A really stunning statistic
that was published in 1905--

there were more operations
performed at St. Mary's Hospital

than there were performed
at Johns Hopkins.

And that's when Rochester
had a population of 7,000

and Baltimore had a population
of half a million.

Narrator: Patients kept coming,
now from all over the world.

Brokaw: I've sent people there.

You can always be assured to
a man and a woman they would

come back like pilgrims
who had been to the holy ground

and say, "I've never been in
a place like that before."

That's why you have these
metaphors of Lourdes,

of Mecca--people making
their way across vast

distances, and that's how
the public perceived it.

This was where you would go
for that case that couldn't be

helped elsewhere.

Man: When you've been given the
diagnosis of pancreatic cancer

in the back of your mind,
you know it's a death sentence.

It's like being hit by a
freight train, and all your

senses are gone--you can't
hear anything over the noise

of the train, you
can't feel anything.

Things start racing through
your mind. You know, you're

49 years old and you have
four kids at home, and then

you start looking...you
start looking for answers--

you know, Internet,
other physicians.

There's a lot of pessimism
in the medical community

regarding pancreatic cancer.

And it was pretty clear.
"Get your affairs in order."

You have two options,
do nothing and die

or take a chance on living.

The choice is easy.

You just need a physician,
a surgeon, that's willing

to have that same mindset.

Man: Mr. Schenk came to me with
a very advanced pancreas cancer.

His tumor was essentially
involving all the critical

major blood vessels
in his abdomen.

By any standard definition,

he would never be
a surgical candidate.

Schenk: The normal protocol for
pancreatic cancer is to do

the surgery first, and then
treat with chemotherapy.

The protocols here at Mayo
are reversed from that,

and they're having
much better results.

Truty: I do tend to take
the patients that are

denied care elsewhere,
being deemed "nonsurgical."

We're delivering specific
therapies that are currently

available in the right dose--

knowing when to stop, when to
move on to the next therapy.

And in the end, he ended up
with an operation that's never

been done before...
with an outstanding result.

It was met with a
lot of skepticism.

That's the one thing that's
always surprised me, at least

in medicine and even cancer
in general--when you want to

bring a new viewpoint, there's
a lot of pushback from people

that have been doing it a
certain way for many decades.

[Sea gulls crying]

Schenk: Currently,
I am in remission.

They can find no cancer
in my body at this time.

I think Dr. Truty got it.

I've got another 25, 30 years
in front of me, for sure.

Here at Mayo,
you are a person.

When no one else believed,

when no one else was
giving me options,

Mark wouldn't give up.

If nothing else,

even if your time's limited,

you can walk away
from Mayo with hope.

Woman: I think there are many
things that really qualified

the Sisters to be nurses.

I think it was their empathetic
approach to patient care,

it's the humility that
they brought to their work

and how they worked
with each other.

It was their Franciscan
values, which we really carry

into the work
that we do today.

Woman: Nursing would definitely
be the frontline of medicine.

We are with the patients 24/7.

We are monitoring them 24/7.

And we're gonna be the first to
try and make things better.

I know that the Sisters
started it, and,

um, I think there's a sense
of pride with that.

There'd be many nights when
I would be leaving work at 8:00,

9:00 at night,

and Sister Generose would be
rolling up her sleeves.

I remember Sister Vera
walking the halls when she was

101 or 102,
something like that.

Let's face it, we can't
compete with the Sisters,

but if we could do that little
fraction of what they've been

able to do, that yeah, wow,
that would be an honor.

I would like to think that
tradition can carry on.

Narrator:
On November 19, 1906,

St. Mary's Hospital Training
School for Nurses

opened its doors.

The curriculum combined
lectures on anatomy,

physiology, and bacteriology,
along with classes

in practical nursing
and hygiene.

Students were required to attend
at least 8 autopsies.

One of the things that was
taught to me by Sister Cashell,

who is one of the nuns here
who I sat down with, she said

when she went through the
nursing school, everyone was

taught to look at every
patient like Jesus Christ.

Narrator: Evidence of the
Sisters' faith and the Mayos'

generosity was everywhere.

When Dr. Will learned that a
farmer had mortgaged his farm

to pay for his surgery, he
not only returned the check,

he sent some extra money
to help the family out

until the man recovered.

Fye: In small towns,
the populace really had
very little money,

often almost no money.

As the Mayo Practice grew,
and more well-to-do patients

traveled to Rochester,
they would see how much

an individual actually
was capable of paying

and charge accordingly.

The individual, if they were
well-to-do, should be able to

recognize that.

On the other hand, poorer
patients who didn't have the

means, it wouldn't be that
they would refuse to serve them.

They used the sort
of principle of Robin Hood,

that they would take the fees
that they got from the wealthy

individuals and they would
sort of spread those over

and cover the cost of
care for the poor.

Narrator: All along, the
brothers maintained their

exhaustive schedules.

One visiting doctor claimed
to have seen Dr. Charlie remove

a cataract, tonsils,
and a goiter,

resect ribs after draining fluid
from a patient's lung, perform

a complex surgery to reconnect
the stomach and intestines,

treat a uterine abnormality,
correct bowlegs,
and cut off bunions--

all before
going home for lunch.

Man: "The gracious privilege is
not often accorded mortal man

"to live to witness
the accomplishment,

"the culmination of his
best wishes, his ideals.

"That this happiness had come
to me after many days fills

my heart with deepest
gratitude and peace."

Narrator: In 1910,
while trying to fix a machine

he had constructed to make
ethanol from corn, W.W.'s
hand was crushed.

His son Charlie
had to amputate.

There were complications.

Infections set in.

His sons couldn't save him.

Dr. William Worrall Mayo,
the doctor whose unorthodox

collaboration with
the Sisters of St. Francis

had transformed the
practice of medicine,

died on March 6, 1911.

He was 91 years old.

[Computer keyboard clicking]

Stevens: Healthcare systems gone
a bit overboard by assuming that

consumerism and competition
alone will somehow or other

clean up everything,
and it hasn't.

And there's a great deal of
frustration because of the way

in which health
insurance is organized,

but the idealism
is still there.

And I hope the age of
consumerism in healthcare will

be followed by an age of
idealism where organizations

feel that they have an
obligation to do the very best,

no matter what the cost.

What we do kind of...

Feenstra: Healthcare
is a customer
service-based experience.

And I hate using the word
"customer service" because it

makes it sound like I'm at
Applebee's, you know, about

to tip the waitress.

We had a lot of different
experiences with different

healthcare across the nation.

What blew me away about the
Mayo experience was that it

showed me what was
lacking in other places.

Keole: In Abby's case, we want
to treat the cavity where

the tumor has been resected.

X-ray therapy, which is what
99.5% of centers in this

country use, goes in through
the patient, out the patient,

and exits on the other side.

Proton therapy is a charged
particle. It'll go a set

distance in tissue,
then stops on a dime.

And literally all the energy
gets released right

at that point.

And that's how we
kill the cancer.

We should be able to
completely spare that area

of the brain that's the most
important part of learning

in a child,

so we reduce the
long-term complications.

We recognize there's a huge
controversy over price.

Proton therapy is a $360 million
investment by Mayo Clinic.

Cost--it's an important topic,
especially in today's

health economics
environment, where our

healthcare costs are
spiraling, but if protons

could be built and operated
for the same exact cost as

X-ray therapy, we wouldn't
even be having this

discussion today.

So at Mayo Clinic, we decided,
we're gonna charge exactly the

same for proton therapy as
we do for X-ray therapy.

We are gonna eat this cost.

Alyssa Feenstra: We go home
from treatment, and she is
a normal 18-month-old.

We are coming to an end,
and I just--

I couldn't have asked
for anything better for her.

I've never experienced
healthcare in a team

like Abigail has.

Just watching her go through
this, there's hope

for her future.

Narrator:
By the time W.W. died in 1911,
it was clear that the Mayo

brothers' practice
had outgrown its space

in the Masonic Temple, as well
as the temporary offices they

had been renting around town.

They needed their
own building.

The 5-story structure,
designed by Henry Plummer,

opened on March 6, 1914.

It stood on the site of W.W.
and Louise's first home,

where Dr. Charlie had been
born 50 years earlier.

Etched in stone over the front
entrance were the two words

that people had been using
for years: "Mayo Clinic."

In addition to dozens of rooms
for examinations, diagnostic

procedures, and outpatient
surgeries, there were clinical

and research laboratories,
a library, assembly hall,

pathology museum, and
an artist's studio

to illustrate illnesses.

The medical records department
alone took up 15 rooms.

Man: "My brother and I had
paid for our homes.

"Our clinic was on its feet.

"Patients kept coming.

"Our theories seemed
to be working out.

"Money began to pile up.

"To us, it seemed to be
more money than any two men

"had any right to have.

"That money seemed, somehow,
like holy money to us.

"It had to go back into
the service of the humanity

that had paid it to us."

Will Mayo.

Dacy: The brothers grew
up in the Gilded Age.

Vast fortunes were being made,

but they had grown up
seeing their father waive

or reduce his charges,
they were inspired by

the Franciscan Sisters.

Dr. Will and Charlie believed,
if you have certain skills,

abilities, resources,
you hold them in trust

to give back to other people,

and they applied that through
the profession of medicine.

Man: "My interest
and my brother's interest

"is to train men for
the service of humanity.

"What can I do with
one pair of hands?

"But if I can train 50 or
500 pairs of hands, I have

"implanted ideals and
scientific spirit in many who

in endless chains will
carry on the same endeavor."

Narrator: In February 1915,
the Mayo brothers endowed the

Mayo Foundation for Medical
Education and Research

with the University
of Minnesota.

Their goal was to set a
higher standard for training

medical specialists.

It ultimately made Mayo
one of the largest centers

of graduate medical
education in the world.

Greene: Education is core
to Mayo's being.

Will and Charlie, they
invested heavily in it.

It's the premise on which
the future of Mayo will lie,

because we're trying to embody
that level of teamwork and all

that we do for every young
person that decides to get

an education here,

when they see the future and see
something that they can build

that's greater than
what they've inherited.

Man: "The great contribution
we can make is to prepare the

"oncoming generations to think
that they can and will

think for themselves."

Charlie Mayo.

[Gunfire, men shouting]

[Whistle blowing]

Narrator: After the United
States entered the Great War

in 1917, a "Mayo Unit"
was set up in France near

the Belgian border,
where they cared for more
than 7,000 soldiers.

Those left behind in
Rochester struggled under

the increased workload.

Things got worse when the
Spanish influenza broke out

in the fall of 1918.

It ultimately killed
millions more than had died

in the World War.

Dr. Charlie himself developed
a serious case of pneumonia

and Dr. Will had jaundice
so severe that he suspected

it was liver cancer.

Both survived, but the
experiences made them even

more aware of the need to
prepare for a time when they

could no longer
lead their clinic.

On October 8, 1919, having set
aside enough to support their

families, Dr. Will, Dr. Charlie,
and their wives transferred

a significant portion of
their personal savings, along

with all Mayo Clinic assets
and future earnings,

to a trust called the Mayo
Properties Association.

They further stipulated that,
from then on, all proceeds

beyond operating expenses
would go to "education,

research, and patient care."

Woman: They wanted to make sure
that they turned over all the

assets to the greater good.

If it remained privately
owned, money would become part

of the dynamics and take away
from what the mission was.

The family had to let go
of the authority it had

over the practice.

That meant all generations
would also forfeit that,

and if they would have
a place in the institution,

it would be earned.

Narrator: From then on, the
Clinic would be run by a Board

of Governors, comprised almost
entirely of Mayo doctors.

"We have in this way,"
Dr. Will said, "established

a medical democracy."

The Mayos also insisted that
they, their partners, and all

future Mayo physicians would
be on salary and would not

profit personally from the
proceeds of the practice.

Boes: Will and Charlie's
idea about putting
the faculty members

on salaries was brilliant
in many ways.

In private practice, it's
a fee-for-service situation,

so if you see more patients,
you make more money.

That leads some physicians
to see more patients in a day,

and that leads to them being
able to spend less time

with the patient.

The Mayo physicians, they
were gonna get paid the same

whether they ordered
the test or not,

whether they referred the
patient for surgery or not.

We choose to be here because
we value this teamwork

and this environment over
our own compensation.

This place tends
to select people

who want to have
that type of teamwork.

Man: Doctors that are at the
very top of their profession,

they could be anywhere, and yet

they've decided to stay
with Mayo.

There are people there who
could be making 10 times

the amount of money that
they're making at Mayo,

but they're devoted
to their profession and their

science of medicine
and healing people.

Noseworthy:
There will never be a decision
made about patient care that

benefits the physician.

It's always about the patient.

That helps us keep pure
our decisions going forward,

that the collective whole
is better than the sum

from any individual.

At Mayo Clinic, you are never
alone in your efforts to find

an answer to that
patient's problem.

Narrator: By 1920,
only a quarter of the medical

staff at the Mayo
Clinic were surgeons.

The rest were physicians
and scientists who not only

examined and diagnosed
patients, but also now

researched the underlying
causes of disease in order to

improve surgical outcomes
and develop

non-surgical treatments.

It was the rapidly growing
field of internal medicine,

and the Mayo Clinic
was at the forefront.

Henry Plummer and Walter
Boothby's discovery in 1923

of how to treat enlarged
thyroid glands with iodine

before surgery greatly
reduced mortality rates.

Dr. Albert Broders had made
a major contribution to cancer

diagnosis by developing a
technique for grading tumors

based on how likely the
mutated cells were to spread.

In 1922, Dr. Russell Wilder
and 4 colleagues

conducted one of the earliest
clinical trials of insulin.

Within a year, more than
20,000 diabetic patients

in the United States were
being successfully treated.

Man: In many institutions, there
are researchers and there are

clinicians, and they can both
be excellent, but there are

very few, uh, institutions
where they both come together.

Man: To be both a physician and
scientist, if we can identify

disease at its purest form,
we'll be able to, in a very

minimally invasive way,
dramatically change the life

course of an individual.

Sierra: Atta has been doing some
innovative work, in cardiac

regeneration in regards
to heart failure.

And that is what we've also
used as our bridge to work

in my field, which
is in orthopedics.

We take cells from an
individual and also try

to regenerate bone.

Boughey: I've enjoyed some
research on evaluating the role

of surgery, in particular
surgery of the lymph nodes,

in terms of patients
with breast cancer.

I think Mayo Clinic has been
dedicated to research since

the founders themselves were.

The Mayo brothers wrote about
the possible role of germs

in cancer.

And that's come to be true.

Behfar:
Will and Charlie, setting up
the concept of investigation

as part of your practice,
created a culture at Mayo

right from its origins.

If we have a careful
consideration of the patients'

welfare in mind, and if
we show scientifically

the evidence for our
discovery, then it's

an irrefutable finding.

That's when true innovation
occurs in medicine.

[Orchestra playing]

Man: First time I noticed
something was not quite right,

the rehearsal started,
and I started drawing a very

slow bow, and for the first
time ever, I noticed a little

tiny shake in my bow arm,

the arm that needs to have

absolute, perfect control.

And as a musician, that's
when you start panicking.

I must have gone to about
15 different doctors,

and no one could really
come up with an answer.

I considered the possibility
this was the end of my career.

He started to play his violin,
and it was clear

that he couldn't play.

And he said, "Can you
help me with this?"

Frisch: Dr. Lee,
he said to me,

"I've been working on
a technique that

involves drilling
a hole in your head."

I had one reaction:
"No one is ever drilling

a hole in my head."

But after three months of the
tremor getting worse and worse,

someone drilling a hole in
my head maybe wasn't such

a bad idea.

Lee: Deep Brain Stimulation--

it's a technique
where we can target

anywhere in the brain with an
electrode and stimulate that

area of the brain, and what we
find, amazingly, is that

our patients with tremor,
we can actually make

those symptoms go away.

Frisch: I was fully awake,
and you have to be, because

they needed me to play violin
during the surgery.

[Plays shaky notes]

Lee: OK, very clearly
he has a tremor.

Frisch: Dr. Lee inserted
the first lead, and I
started to play...

[Playing steadier notes]

and the tremor
was much better,

but only much better.

Lee: Roger,
what do you think?

It wasn't good enough to
play professionally.

Lee: You actually--you
still have a little
bit of tremor left,

but you're right,
it is better.Great.

The question is, whether
we should insert
that second lead.

Lee: OK.

Frisch: They inserted
the second lead,

and I drew a bow and
it was perfectly steady.

[Playing strong, steady notes]

They give me this little
control switch, which I always

think is like a garage door
opener, but I can actually

turn myself on and off.

[Beep]

It says I'm off now, and it's
that simple, and if you wait

about 5 seconds, then it
really does kick in almost--

almost right away.

[Playing jarring,
scraping-sounding notes]

And as hard as I try,
that's as smooth as I get,

and you can see the
bow just shaking,

just me holding it.

[Beeps twice]

So I--now I'm back on again.

And wait about 5 seconds...

[Playing classical music
perfectly]

Lee: What we often say in the
lab, "Patients are waiting."

And so we have to discover
the new cures...today,

that we're on a mission to help
the patient in a timely fashion.

This is not a theoretical
academic exercise that we're

trying to do.

We want the cure because
we see the patient

suffering today.

[Dalai Lama speaking]

[Train whistle blowing]

When the patients really started
an influx to the community,

they saw that there was a
need for additional hotels,

for restaurants to dine in,
and the community

really embraced Mayo Clinic.

Brokaw: It's where it is,
in Minnesota, and it reflects

the values and it absorbs
the values of Minnesota.

Aksamit:
This Midwestern ethic drove
the people around the clinic

and the hospital to take
care of the people,

give of themselves, sometimes
at great personal sacrifice,

to make it an excellent place.

Noseworthy:
It's the person who opens
the door, it's the person who

meets them in the hallways,
it's the person who says,

"You look lost. Can I
help you find your way?"

It's the desk attendant,
it's the secretary, it's

the custodian--it's pervasive.

Narrator:
By the mid-twenties, more than
60,000 patients were arriving

at the Mayo Clinic every year.

In response, St. Mary's
built an impressive new

surgical pavilion.

At the same time, local
businessman John Kahler

constructed several innovative
hotel-hospitals that could

accommodate the massive
influx of patients

and their families.

Eventually, Kahler's
healthcare facilities would

evolve into a new
non-profit hospital called

Rochester Methodist.

The Mayo Clinic was
overwhelmed, too.

Henry Plummer agreed
to oversee yet another

expansion project.

Completed in 1928,
the $3 million, 17-story

Plummer building was the
tallest in the state.

Constructed of limestone and
brick, it featured marble from

France, Germany, and Italy;
hand-carved ornamental designs;

two solid bronze doors; and
an 18-ton, 23-bell carillon.

[Bells ringing]

Plummer devised an
ingenious series of lifts to

automatically deliver medical
records to designated floors

before patients arrived
for their appointments.

He also developed an array of
signal lights outside the

exam rooms so nurses
could track the status

of every appointment.

There was even a system
of pneumatic tubes to send

medical records and specimens
between the Mayo Clinic

and St. Mary's Hospital
a mile away.

Mukherjee: The Mayo Clinic
is an engineering wonder.

If you go to the Mayo, you all
of a sudden find this highly

integrated and
engineered system,

like a well-oiled machine,
and it comes from Plummer's

vision and the Mayos' vision.

It comes from the idea that

all these pieces, uh,
which were spread out,

are part of
the same clockwork.

Man: "Medicine is both
an art and a science,

and both make appeal
to the true physician."

Charlie Mayo.

Dacy: The Mayos
insisted on a degree

of distinction in Mayo
Clinic buildings.

For many patients, this
will be their encounter

with beautiful architecture
and design and art.

It's so important to put them
in a frame of mind of healing.

Fast-forward to
Cesar Pelli, the designer

of the Gonda building.

He said, "Healing begins
when you walk in the door.

"Before you ever see your
doctor, you have this sense,

I've come to
a good place."

We have the piano in the lobby.
We have performances.

All this is part of the
healing mission of Mayo.

[Playing classical music]

Narrator:
But for all its innovation
and success, The Mayo Clinic is

not a perfect place.

Access is problematic.

Diseases are relentless,
their cures elusive.

Mistakes are made.

Patients are misdiagnosed.

Treatments fail.

People die.

Truty: Every physician has
a personal private cemetery

in the back
of their minds.

It's a graveyard of all their
previous patients that they

failed, and it's a place that
we all go to to reflect upon,

upon our shortcomings
and we try to decide,
how do we improve upon this?

Rhodes: Sometimes the
body is unexplainable,

and those times
really eat at me.

We have to guard against
the illusion of greatness.

We have to earn our
greatness every day.

I have personal stories
of failure.

I have institutional
stories of failure.

We have to speak
about those openly.

Narrator:
Occasionally, Mayo's emphasis
on putting the patient first

has led to decisions in
direct conflict with its

original values.

Although the Clinic welcomed
patients of all races

and regularly invited minority
doctors as distinguished guests,

they, as at most
hospitals across the country,

were not allowed to treat
white patients, who might not

be comfortable with
a black doctor.

There wouldn't be an African-
American physician on staff

until 1979.

Wald: It's a challenging point
in our history that we have

to acknowledge.

That was the decision that
was made because that was

the culture of our time.

The decisions that we make,
yes, are ultimately

about the patients, but if
you're not serving the staff

the same way, then you
ultimately don't serve
those patients.

We just have to learn from
things that we've done

in the past, and get to a
new point for our future.

Kelly: Here I am.

I don't know if it's gonna
be the same diagnosis, that I

have myositis, or it might
be something else, but, um,

I'm hopeful.

The tips
of my fingers...

Kelly: The discussion
with Dr. Kennelly,

she listened to what
I was saying.

So, I go to him, like,
every 3 months.

Kelly: I hadn't had
that in the past.

It was, like, here...

I mean, she took
her time with me.

She didn't rush me.

She explained
everything to me.

And--and were you
just getting
progressively worse?

Kennelly:
Inclusion body myositis is a
category of muscle disorders

that are thought to
be inflammatory.

OK.

It's a tough one because
it's kind of creepy-crawly.

It doesn't come on
like gangbusters.

It sneaks up on people.

And don't let me
push your head back.

Kelly: I noticed that they was
on the ball of doing different

stuff, you know, checking my
blood, doing stuff that I felt

like I should have had done in
the beginning at a early stage,

and it wasn't
done like that.

I come here, and they--
they on the ball

of boom, boom, boom,
boom, doing this.

30 minutes--I'm on the road
driving home, and Dr. Kennelly

called me and she said, "I
got your test results back."

I said, "You got my
test results back?"

Because normally when you take
blood work, it takes a couple

weeks before you can
get your results back.

And she said, "Well, it does
look like you have diabetes."

And she said, "Have they
ever told you your white cells

was high?"

Kennelly:
The blood work was important,

and her white blood cell count
is markedly elevated.

And then another thing...

Kennelly:
For Mrs. Kelly, I'm asking for
the hematologist to see her,

and I'm asking for the
endocrinology department

to see her.

I think we will be able to
give her a definitive answer.

I'm still most suspicious
that she has

this inclusion body myositis,

but it's possible that the
elevated white blood cell count

could be affecting
her muscles.

[Man speaking
indistinctly]

That has potentially

nothing to do with her
muscle disease...

Now, interestingly
enough...

but it might.

They found that your
white count is high.

May be indication for
a low-grade leukemia.

Mm-hmm.

One that sometimes is
associated with these

muscle inflammatory
processes.

So we may have
the cause...

Kelly: Leukemia. That was
not something that I thought
was gonna be told to me.

It was--
it was devastating.

It's quite likely that she may
had had it at least

for 10 or 15 years or
could be even longer.

Cranial cell leukemia
had been associated

with this inclusion
body myositis,

so we approached her condition
with some chemotherapy

directed to the leukemia and
another medication directed

to the myositis.

Kelly: I went for 8 weeks,

and I felt like it worked
in the beginning.

Then my husband lost his job,

and I wasn't able to continue
to go to the Mayo Clinic

'cause I lost my insurance.

And so I had to
seek other places.

What other option do you have?

Trying to get in to see
someone, it's a--

it's a battle, you know?

Who wants for somebody
like me to come in,

and I got
all these problems?

The main thing come out
their mouth,

"How would you like to
pay for this?" you know.

Things cost money,

and the Mayo Clinic,
it's not free.

But if I was able to continue
treatments, I felt like

the Mayo Clinic was
my hope to help me.

Colon-Otero:
I visited with her after
she had lost her insurance

and was able to
examine her and determine

where we stood
with her treatment.

And her condition doesn't
seem to have improved

that much at this point.

Kelly: You know, sometime it
doesn't work like you want it to

in the beginning.

I got weaker.

But he looked me dead
in my eye.

He said, "You can live
a long life.

You can live a long
life with leukemia."

So all hope is not gone.

They did all they
could do for me.

I thank them from the bottom
of my heart to give me answers

to what I was looking for.

You know, you just
have to move on.

That's what I'm
trying to do now.

I know in the beginning it
was gonna be a journey, and it

still is a journey, and hey,
it's still going.

Narrator:
One day in 1928,

Dr. Will arrived
at his office and told

his secretary that he'd just
performed his last operation.

He had developed a slight
tremor in his hands.

When she protested,
he explained, "I want to stop

while I'm still good."

Meanwhile, Dr. Charlie's son,
who was known as Dr. Chuck,

had received his medical
degree and was looking forward

to working with his father,
just as young Charlie and Will

had worked side by side
with their father.

Man: "I had been dreaming
for years of being
his first assistant,

"amazing and impressing
him with my skill.

"I thought, I suppose, that
it would draw us together.

But fate gave me only that
one morning to prove myself."

Narrator: On Dr. Chuck's very
first day as surgical assistant,

his father suffered
a dizzy spell.

It turned out to be the first
of a series of minor strokes.

Dr. Charlie's surgical
days were over, too.

Weivoda:
I think the Mayos thought
about the future all the time.

I don't think they ever looked
back over their shoulder.

I think it was always,

"I'll deal with what
I've got in front of me,

"but how do I face
the next thing,

and what is the next thing?"

Man, on radio: My friends,
I want to talk for a few minutes

with the people of the
United States about...

...tell you what has been
done in the last...

Narrator: The Great Depression
tested the Mayo Clinic

as no other event.

Doctors and staff accepted
pay cuts to minimize layoffs.

The Clinic printed "Mayo
money" in case employees

needed help paying
for rent and food.

No one was turned away because
of their inability to pay,

but the number of patients
seeking treatment

fell dramatically.

At St. Mary's, the situation
was even more precarious.

But having made vows
of poverty,

the Sisters knew how to adapt.

They raised turkeys and
chickens, harvested acres

of fruits and vegetables,
and pasteurized almost

a quarter of a million gallons
of milk a year, which they not

only used to feed their
patients, but also shared

with the many needy people who
were arriving at their door

begging for food.

The reduced patient loads
during the Depression did give

doctors time to do experiments
they had been putting off.

Edward Kendall and Philip Hench
began work that would

lead to the discovery of
cortisone, for which they

would be awarded
a Nobel Prize.

Dr. Hugh Butt discovered that
Vitamin K could save the lives

of patients with jaundice.

And Dr. John Lundy established
one of the nation's first

blood banks.

[Cheering and applause]

On Wednesday, August 8th,
1934, with temperatures

in the 90s, 75,000 people--
3 times the city's population--

gathered along
Broadway to see

President Franklin Roosevelt
ride with Dr. Will

and Dr. Charlie from the
train station through town.

FDR had come to present the
Mayos with an award from the

American Legion in honor of
their service to the country,

which included providing free
care to World War I veterans.

During his visit, Roosevelt
laid a wreath at the grave

of W.W. Mayo
and stopped at St. Mary's

where Sister Joseph Dempsey
came alongside his car

and clasped the
President's hands.

The town had been
preparing for weeks.

A portable stage with a
hidden ramp had been built

so the President could reach
the platform without the crowd

seeing the metal braces on
his legs, crippled by polio.

His 10-minute tribute to the
Mayo brothers was broadcast

on radio throughout
the country.

Roosevelt:
I hope that the people of
Minnesota and of Rochester

will not feel limited in
their pride of possession,

when the nation which I have
the honor to represent claims

the right to call
Dr. Will and Dr. Charlie

by the good word
of "neighbor."

[Cheering and applause]

Woman: "Dear Dr. Markovic...

"I think it's clear that I'm
reaching the end of my road.

"Our gratitude to you and the
Mayo Clinic is beyond words.

"You always have
believed in me and my future,

"despite the unbearable odds
that have been against us.

"You gave me the gift of time,
of months of life that I

"otherwise wouldn't have had.

"Countless times, you gave
my family and I hope

"when we had none.

"You are an inspiration
and a godsend to your patients.

"Your favorite patient,

Claire Richards."

McCain: I can't tell you
how important

the care and concern
and the affection

that the people
at Mayo treated me with

had such a beneficial effect
on my health.

I realize that all
of this time of ours

comes to an end.

They've been very straight
with me, and they've told
me the odds

and they've told me exactly
what they're doing.

And, uh, that's--
that's so important.

It's so important because
then you can plan

what time you have left.

Narrator:
Will and Charlie Mayo now
spent much of the winter

in side-by-side adobe
houses they had built

in Tucson, Arizona.

At 8 A.M. every morning, they
would meet at Charlie's house

to review news
from the Clinic.

"Well, well," Charlie
once said, "This is quite

"a comedown for us, Will.

They're doing better
now that we're away."

In 1938, the Mayo Clinic
officially treated its

one-millionth patient,

but there would be
little else to celebrate.

Sister Joseph, the resourceful
82 year-old leader

of St. Mary's Hospital
for 4 decades, had retired.

She could still be found
visiting patients at St. Mary's,

particularly children,
the poor, and alcoholics.

But early that next Spring,
she came down with pneumonia

and died on March 29, 1939,

surrounded by her
Franciscan Sisters.

In April, Dr. Will began
having stomach pains.

An X-ray showed it was cancer.

The man who had operated on
so many abdominal tumors

now had a tumor of his own
removed by a Mayo surgical team.

Will seemed to be recovering,
but then his brother Charlie

came down with a serious
case of pneumonia.

Man: "Granddaddy was sitting
straight up in a high-back

"rose-colored chair.

"His glasses had slipped
low on his nose,

"and his mouth allowed
soft air to escape.

"Granny was leaning
over him.

"'Isn't he beautiful?'
she said.

"'Isn't he the most
handsome man?'

"I asked her what
she was doing.

"She said she was
memorizing his face

"'in case he leaves me first.

I want to remember
what he looks like.'"

Narrator: Dr. Charlie
died on May 26, 1939.

Man: "Not long after Father
died, Uncle Will noted

"with professional
interest that he was

"becoming jaundiced.

"He diagnosed it at once as
metastasis in his liver.

"He went about his death in the
same practical, crisp manner,

"with no self-pity.

"He summoned the family.
'I've had a good life,

"'and this is all right.

"'I'm not going to have any
further medication except some

"'morphine for the pain.

I'll say good-bye
to you now.'"

Narrator: On July 28th,
Dr. Will died.

Noseworthy: It must have
been a tremendously solemn time

at Mayo Clinic

to lose those three--
those three leaders.

An awful lot of people believed
that when the Mayo brothers died

that the clinic
would go into decline,

and it didn't.

Others believed that as
change occurred in society

that the need for the Mayo
Clinic and its success would

go into decline, and
none of that happened.

The clinic has grown and
has flourished long after

the Mayo brothers
left this earth.

[Machine beeping]

Woman: Over 2 years, I have
seen 40 different doctors,

and I have been admitted
120 times at my local hospital.

And no diagnosis.

My liver was failing, and then
it went to my kidneys and to

my lungs, and then it
went to my heart.

I have been
revived 7 times.

I always felt like I was passed
on from one doctor to another.

They did not know
what was wrong.

They kept me alive,
but they never gave me

any kind of hope.

They said I would not
make it past 35.

Man: You might see a lung
doctor, and you have to go see

a kidney doctor somewhere
else, but for Shannon,

she's thinking, "It should be
one thing that's linking

"these things together,
and I'm not sure anyone's

really got that yet."

I think most physicians are
well-meaning, honestly, and they

want to try to work within
these systems, but it's

difficult when everything
is so fragmented.

This is the healthcare
system in the U.S.

that we're running
into as patients.

Leon: Dr. Niewold was
the start of my hope.

I had many, many tests,
and the consultation

between me and him lasted
about 2 hours.

I just told him what was
wrong and all my symptoms.

He sent me back to
the waiting room...

and 20 minutes later,

exactly 20 minutes,
he called me back

and gave me a diagnosis--

Lupus.

Between 4 and 5 years
and no diagnosis,

and 20 minutes
with Dr. Niewold.

It was like a total miracle.

Niewold:
The pace of medical knowledge
isn't gonna slow down, and I

think it does take more of a
distributed mindset to be able

to handle all of that and
apply it to patient care.

[Klaxon sounds]

[Gunfire]

[Men shouting indistinctly]

Narrator:
The Mayo Clinic sponsored
several medical teams during

the Second World War,
including one

in the Philippines.

Led by Charlie's son Dr. Chuck,
it built hospitals

in the jungle, where they
treated both Allied

and Japanese soldiers.

In the new Medical Sciences
Building, a top-secret

Aeromedical Unit developed
an inflatable "G-suit" that

protected Allied pilots from
blacking out on steep dives.

The Aeromedical Unit had cost
the Mayo Clinic $2 million.

They charged the United
States government

$1.00.

In the years ahead,
Mayo doctors and nurses would

help assemble MASH units for
the Korean War, devise plans

to deal with potential mass
casualties during the Cold War,

and, after 9/11,
developed a rapid test

to diagnose anthrax.

Mayo doctors also used
the first CT scanner

in the country, pioneered
the use of computers
in operating rooms,

performed the first
series of successful surgeries

using a heart-lung bypass
machine, developed one

of the first combined
liver-heart transplant programs,

and the Mayo Clinic has
helped the medical community

accelerate the pace
of stem cell, gene-based,

and other individualized
therapies.

Man: "The greatest asset
of a nation is the health
of its people.

"The medical profession can be
the greatest factor for good

"in America.

"Our failures as a
profession are the failures

"of individualism, the result
of competitive medicine.

[Gavel banging]

It must be done by
collective effort."

Will Mayo.

Narrator: The biggest challenge
facing the Mayo Clinic,

and every other
hospital and doctor

in America, would be
the question of cost

and delivery
of health-care.

For more than 50 years,
as the country argued over

what it owed its citizens,
the Mayo Clinic would struggle

to remain true to the
values W.W. had instilled

in his sons.

Stevens: With Medicare and
Medicaid, everybody was to have

good health insurance.

Well, that didn't actually
work out as planned.

There was supposed
to be health

maintenance organizations,

and that didn't work well.

There was supposed to be
regional health planning,

and that didn't work.

Most recently, we've had this
consumer-oriented movement--

competition will bring
down costs, we'll make it

more efficient.

Well, that hasn't worked.

Brokaw: It's appalling how
little they know in Washington

about how it really works.

The most important thing that
our lawmakers can learn from

the Mayo Clinic system is it's
the team effort, that everybody

is involved, not just in
the treatment, not just

in the diagnosis,
but also in the system

and how it operates,
trying to keep cost down.

Citizens of the United
States expect and deserve

a sustainable, high-quality
health care system that brings

innovation and research to
their needs when they need it.

Stevens: One of the messages
from Mayo's history is that you

can be entrepreneurial and
competitive and idealistic

and put the patient first
all at the same time.

And that is the message
now that leaders of these

organizations all across the
country are trying to tackle.

Wald: We're not trying
to solve healthcare.

We're trying to do it.

From a healthcare
professional's perspective,

this is medicine.

This is what it was
supposed to be.

We'll do what's in the best
interest of the patient,

and the rest of it
will fall into place.

Mukherjee: The Mayo
is on a historic pedestal,

but it needs to be maintained,
not just dusted

like a sculpture on a pedestal,
but really maintained in a way

that the physiology of the
institution remains active

and viable and vital.

It's an island of
excellent medical care,

and that has its problems.

How to translate that model
into extremely diverse

communities has remained
a huge challenge.

Narrator: In 1986,
St. Mary's Hospital,

the Mayo Clinic,
and Rochester Methodist Hospital

merged
as an integrated center

of medicine with total
assets of $1 billion.

Gervais: At the time when we
were merging, the lawyer wanted

a copy of our contract with
the Mayo clinic, and I said,

"Well, I'm sorry, we
don't have a contract
with the Mayo Clinic."

He said, "Oh, you must
have a contract someplace."

And I said, "No, we have
never had a contract

with the Mayo Clinic."

He said, "Well...
how do you function?

How do you get along?"

And I said, "Well, I'm not
being facetious, but if there

"is a problem, the departments
concerned about it get together,

"they discuss
possible solutions,

"they decide what is
the best solution,

and both parties
set about doing it."

And he looked at me and he
said, "You just destroyed

a profession."

I said, "Good."

Man: "We know who we are
with the Sisters,

but we don't know who
we'd be without them."

Narrator: The Mayo Clinic,
which started

in a frontier doctor's office
in a small Minnesota town,

would go on to create
medical centers
in Jacksonville, Florida,

and Scottsdale, Arizona,

the regional Mayo Clinic
Health System,

the Mayo Clinic College
of Medicine and Science,

and a worldwide network of
like-minded hospitals,

all dedicated to working
together to find new ways

to perfect the Mayos'
belief that the needs

of the patient must
always come first.

Weivoda: I don't think it's
a miracle in the cornfield.

I think it's what
humanity should be,

where people do the right
thing, not because they're

looking for money, not because
they're looking for fame

or glory, but they do
the right thing.

Truty: People need to
have the Mayo Clinic.

They require that we exist.

They need a place like this in
America, in the United States,

that offers hope where sometimes
hope isn't offered elsewhere.

Mukherjee: I think what the
Mayo does is not peddle hope.

What it peddles is excellence.

Hope is a consequence
of excellent delivery

of medical care,
and integration is

a consequence of being able
to be the most thoughtful,

the most excellent, the most
incisive in medicine.

Dacy: A lot of people have
a sense that the Mayos

are with us today,

so they don't feel
remote to us at all.

And we have a sense that
whatever we're doing, maybe

they're looking over our
shoulder, and that keeps us

on our game.

Man: "I look through
a half-opened door
into the future,

"full of interest, intriguing
beyond my power to describe,

"but with a full understanding
that it is for each generation

"to solve its own problems
and that no man has the wisdom

to guide or control
the next generation."

Will Mayo.